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General NPI Number Information
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NPI Number | 1427164862
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Entity Type | Organization
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Legal Business Name | SLATEBELT DRUGS INC
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 02/09/2012
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Provider Practice Location Address
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Address Line | 435 BLUE VALLEY DR
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City | BANGOR
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State | PA
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Zip | 18013-1513
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Country | US
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Telephone | 610-863-6001
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Fax | 610-863-8343
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Provider Business Mailing Address
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Address Line | 435 BLUE VALLEY DR
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City | BANGOR
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State | PA
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Zip | 18013-1513
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Country | US
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Telephone | 610-863-6001
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Fax | 610-863-8343
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Authorized Official
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Title or Position | PRESIDENT
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Name | VISWANADHAM GADEY
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Credential |
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Telephone | 908-454-4352
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PP411186L
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License Number State | PA
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